冠状动脉形态与粥样硬化病变关系的多层螺旋CT研究

 【目的】 探讨冠状动脉的三维形态结构?变异及与冠心病(CAD)发生的相关关系?【方法】 用多层螺旋CT (MSCT)增强方法行冠状动脉造影,通过工作站三维重建处理,观察?测量冠状动脉的分支?位置?形态及其变异,并分析其与冠状动脉粥样硬化病变的关系?【结果】成功进行MSCT冠状动脉造影的病例1057人,发现冠状动脉狭窄面积 > 70%诊为冠心病352例?资料显示左侧优势型的冠心病发病数相对较少,而左冠状动脉主干发出角度较大?主干较短?冠状动脉开口于冠状动脉窦之外变异与冠心病发生有显著相关关系?【结论】 MSCT能够准确地显示冠状动脉管径?三维形态结构;冠状动脉的某些结构如开口变异等可能造成血液动力学改变,导致冠心病的发生?

Research on Relationship between Coronary Artery Variant and Its Sclerotic Disease by Multiple Slice Computed Tomography

Objective] To research the correlativity between coronary artery variation and its coronary artery disease (CAD) with MSCT (multiple slice computed tomography). Methods] Applying contrasted MSCT for coronary arteriongraphy, with 3-D reconstruction at workstation, the author carefully observed and measured these arterial branches, locations, figures and variations, then analyzing some relationships of them with occurrence of CAD. Results] There were 1057 cases of coronary arteries checked up with MSCT angiography, in which 352 cases were diagnosed as CAD whose vessel's sectional dimension had been measured narrowing more than 70%. The data indicated that left coronary dominant type seems have less possibility of CAD occurrence, whereas a larger angles of emergence of left coronary artery, a very short main stem of the artery and a variation of the arterial opening were most possible factors which have significant correlativity with CAD. Conclusions] The stereoscopic coronary arteries could be truly illustrated with MSCT. Some structural variation of coronary arteries such as oral dislocation would probably cause some changement of haemodynamics and further result in occurrence of CAD.